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Appendix <br />ATTACHMENT 3-1: NON COLT USION AFFIDAVIT <br />CERTIFICATIONS <br />IC ATIONS <br />NON -COLLUSION AFFIDAVIT <br />(Title 23 United Stares Code Section 112 and <br />Public Contract Code Section 7106) <br />To the CITY OF SANTA ANA DEPARTMENT OF PUBLIC WORKS <br />In accordance with Tide 23 United States Code Section 112 and Public Contract Code 7106 the BIDDER <br />declares that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, <br />company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the <br />BIDDER has nor directly or indirectly induced or solicited any other BIDDER to put in a false or sham bid, <br />and has not directly or indirectly colluded, conspired, connived or agreed with any BIDDER or anyone else <br />to put in a sham bid, or that anyone shall refrain from bidding; that the BIDDER has not in any manner, <br />directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price <br />of BIDDER orally BIDW'R, or to fix any overhead, profit, or cost element of the bid price, or of that of <br />any other BIDDER, or to secure any advantage against the public body awarding the contract of anyone <br />interested in the proposed contract; that all statements contained in the bid are true; and, further, that the <br />BIDDER has not, directly or indirectly, submitted his o her bid price or any breakdown thereof, or the <br />contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any <br />corporation, partnership, company association, organization, bid depository, or to any member or agent <br />thereof to effectuate a collusive or sham bid. <br />Note: The above Non -collusion Affidavit is part of the Proposal- Signing this Proposal on the <br />signature portion thereof shall also constitute signature of this Non -collusion Affidavit. BIDDERS <br />are cautioned that makin'g a false certification may subject the certifier to criminal prosecution. <br />Signed <br />State of California <br />County of LWAngeles <br />Subscribed and sworn to (or affirmed) before tire on this day of Mkt -"' 20 2/ by [C1Wti4 P"Jr <br />__._....... proved to me on the basis of satisfactory evidence to be the person(i) who appeared <br />before me. <br />E-`---" V CC-C-Cu% Le <br />Notary Public Signature Notary Public Seal <br />LILL10 yALDIYIES6 <br />Sy <br />Public- Calfornia <br />omLm AngelesCountyCommissspn k 2129332 <br />Cm. .Expires May 31, 202{ <br />City of Santa Aria RFP 21-004 Rnl p, Page A3-1 <br />C.ily Council <br />Banbsp;26 lndash;lnbsp;171 <br />b/1 s/2021 <br />@nhsp; <br />